CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Franciscan Health Munster

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $75
Cash Discount Price: $41
vs. Medicare Baseline: 4.08x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Franciscan Health Munster is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 4.08x the Medicare baseline. Located in 701 Superior Ave, Munster, IN.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)

Cash / Self-Pay: $41 (223%)

Insurance Median: $75 (408%)

Cash: $41 (223% of Medicare)

Ins. Median: $75 (408% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $18.39 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 408% of the Medicare baseline (a markup of 308%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$15 - $94	82%
Mdwise [1175]	$18	98%
Medicaid / KanCare	$18 - $22	98%
Medicare (plans)	$18	98%
Unicare [1150]	$18	98%
Managed Health Services [1302]	$21	114%
Workers Comp [1172]	$37	201%
Cigna	$53 - $85	288%
Aetna	$55	299%
Commercial [2001]	$55 - $100	299%
Managed Care [2000]	$55 - $109	299%
Great West Insurance [1055]	$85	462%
United Medical Resources [1158]	$100 - $109	544%
United Medical Resources [1301]	$100 - $109	544%
UnitedHealthcare	$100 - $109	544%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $41.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84153.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Franciscan Health Munster is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 84153.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.